摘要
目的分析初诊Ⅳ期胃癌/食管胃结合部癌肝转移患者的临床病理特征,探索此类患者的预后因素。方法通过美国国立癌症研究所监测、流行病学和最终结果(surveillance,epidemiology,and end results,SEER)*Stat软件收集SEER数据库中2010—2015年1614例Ⅳ期胃癌/食管胃结合部癌患者的临床资料。采用χ2检验比较肝转移(641例)和非肝转移(973例)患者临床病理特征的差异,采用二项分类Logistic回归分析探讨发生肝转移的影响因素;采用Kaplan-Meier法计算总生存(overall survival,OS),通过Log-Rank检验计算各因素OS的差异。通过多因素COX回归模型分析Ⅳ期胃癌/食管胃结合部癌肝转移患者预后的独立危险因素。结果肝转移和非肝转移患者临床病理特征中差异有统计学意义的因素包括:诊断年龄、种族、性别、原发灶部位、T分期、N分期、组织学分型、分化程度(均P<0.05)。二项分类Logistic回归分析结果提示,诊断年龄、种族、性别、原发灶部位、组织学分型、分化程度、骨转移、肺转移均为Ⅳ期胃癌/食管胃结合部癌患者发生肝转移的危险因素(均P<0.05)。641例胃癌/食管胃结合部癌肝转移患者的中位生存时间为3个月。单因素生存分析结果显示,诊断年龄、N分期、组织学分型、分化程度、原发灶手术、肺转移均与Ⅳ期胃癌/食管胃结合部癌肝转移患者生存情况有显著相关性(均P<0.05)。多因素COX回归模型分析显示,诊断年龄、N分期、组织学分型、分化程度、原发灶手术、肺转移均为Ⅳ期胃癌/食管胃结合部癌肝转移患者预后的独立影响因素(均P<0.05)。结论Ⅳ期胃癌/食管胃结合部癌具有独特的临床病理特征。发生肝转移的患者整体预后较差,诊断年龄、N分期、组织学分型、分化程度、原发灶手术和肺转移均为Ⅳ期胃癌/食管胃结合部癌肝转移患者预后的独立影响因素。
Objective To analyze the clinicopathological features of newly diagnosed stageⅣgastric cancer/esophagogastric junction cancer patients with liver metastases,and explore the prognostic factors of these patients.Method The clinical data of 1614 patients with stageⅣgastric cancer/esophagogastric junction cancer from 2010 to 2015 in the surveillance,epid e miology,and end results(SEER)database were collected by SEER*Stat software.The clinicopathological characteristics of patients with liver metastases(641 cases)and non-liver metastases(973 patients)were compared byχ2 test.The Kaplan-Meier method was used to calculate the overall survival(OS),differences between groups were calculated by Log-Rank test.Multivariate COX regression model was used to analyze the independent risk factors for the prognosis of stageⅣgastric cancer/esophagogastric junction cancer patients with liver metastases.Result The statistically significant factors in the clinical characteristics of patients with liver metastases and nonliver metastases included:diagnosis age,race,gender,primary site,T stage,N stage,histological type,and degree of differentiation(all P<0.05).Binomial Logistic regression analysis suggested that diagnosis age,ethnicity,gender,primary site,histological type,degree of differentiation,bone metastasis,and lung metastasis were risk factors for liver metastasis of gastric cancer/esophagogastric junction cancer patients with stageⅣdisease(all P<0.05).The median survival time of 641 patients with liver metastases was 3 months.The univariate analysis results of various clini co p athological factors showed that the diagnosis age,N stage,histological type,degree of differentiation,primary surgery,and lung metastasis were significantly correlated with survival(all P<0.05).Multivariate COX regression models showed that the diagnosis age,N stage,histological type,degree of differentiation,primary surgery,and lung metastasis were all independent factors affecting the prognosis of stageⅣpatients with gastric cancer/esophagogastric junction cancer(all P<0.05).Conclusion Gastric cancer/esophagogastric junction cancer has unique characteristics.The overall prognosis of liver metastasis is poor.Diagnosis age,histological type,N stage,degree of differentiation,primary surgery,and lung metastasis are independent factors affecting the prognosis of stageⅣgastric cancer/esophagogastric junction cancer patients with liver metastasis.
作者
韦青
袁幸
徐琦
李晶晶
陈磊
罗聪
应杰儿
Wei Qing;Yuan Xing;Xu Qi;Li Jingjing;Chen Lei;Luo Cong;Ying Jieer(Department of Abdominal Medical Oncology,Institute of Cancer and Basic Medicine,Chinese Academy of Sciences,Cancer Hospital of the University of Chinese Academy of Sciences,Zhejiang Cancer Hospital,Hangzhou 310022,China)
出处
《肿瘤综合治疗电子杂志》
2020年第2期113-117,共5页
Journal of Multidisciplinary Cancer Management(Electronic Version)
基金
浙江省公益技术应用研究(实验动物)计划(2017C37138)。
关键词
胃癌/食管胃结合部癌
监测、流行病学和最终结果数据库
肝转移
预后
Gastric cancer/esophagogastric junction cancer
Surveillance,epidemiology,and end results database
Liver metastasis
Prognosis
